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This is VAERS ID 269167

Case Details

VAERS ID: 269167 (history)  
Age: 15.0  
Gender: Female  
Location: Illinois  
Vaccinated:2006-10-04
Onset:2006-10-04
   Days after vaccination:0
Submitted: 2007-04-06
   Days after onset:184
Entered: 2006-12-18
   Days after submission:108
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / 0 - / PO

Administered by: Private       Purchased by: Other
Symptoms: Vulvovaginal pruritus
SMQs:

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Asthma
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: WAES0611USA01335

Write-up: Information has been received from a nurse concerning a 12 year old female who on 30 Seo 2006 was vaccinated with the first 0.5 mL dose of Gardasil reported as "oral". On 01 Oct 2006, the patient developed intense vaginal itching. The patient sought unspecified medical attention. On 03 Oct 2006, the patient recovered from the event. Additional information has been requested. This is in follow-up to report (s) previously submitted on 12/14/2006. Information has been received from a medical assistant (previously reported as a nurse) concerning a 15 year old female student (previously reported as a 12 year old) with asthma. On 04-OCT-2006, at 4:30 PM, (previously reported as 30-SEP-2006), the patient was vaccinated in the left deltoid with the first 0.5 mL dose of GARDASIL (Lot # 654540/0800F). There were no illnesses noted at the time of vaccination. On 04-OCT-2006 (previously reported as 01-OCT-2006), at 6:30 PM, the patient developed intense vaginal itching which continued to the day after. It was reported then it stopped abruptly on Day# 3. On 06-OCT-2006, the patient had recovered from the event. Additional information has been requested.


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